Islam S, Oon V, Thomas P
Department of Obstetrics and Gynaecology, Newham University Hospital, London, UK.
J Obstet Gynaecol. 2010 Jan;30(1):38-40. doi: 10.3109/01443610903383358.
This retrospective cohort study was conducted at Newham University Hospital, London to investigate maternal outcome of planned vaginal delivery as well as rate of maternal-to-child transmission. Between June 2004 and June 2006, 23 (16%) women of 144 HIV-infected pregnant women opted for planned vaginal delivery. Offer of vaginal delivery was based on maternal HIV RNA count <50 cells/ml around 36 weeks' gestation. All women received antiretroviral therapy. Fifteen (65%) women achieved vaginal delivery. Babies were followed up over 18 months. All babies had antiretroviral prophylaxis. No babies were breast-fed. There was no report of maternal-to-child transmission in any of these babies. Our study suggests that planned vaginal delivery could be safe with antiretroviral therapy in pregnancy, optimal intrapartum care, viral load of <1000 copies/ml at delivery, retroviral prophylaxis for babies and avoidance of breast-feeding.
这项回顾性队列研究在伦敦的纽汉大学医院开展，旨在调查计划阴道分娩的产妇结局以及母婴传播率。在2004年6月至2006年6月期间，144名感染HIV的孕妇中有23名（16%）选择了计划阴道分娩。阴道分娩的提议基于妊娠36周左右产妇的HIV RNA计数<50个细胞/毫升。所有女性均接受了抗逆转录病毒治疗。15名（65%）女性成功实现阴道分娩。对婴儿进行了18个月以上的随访。所有婴儿均接受了抗逆转录病毒预防治疗。没有婴儿进行母乳喂养。这些婴儿中均未报告母婴传播情况。我们的研究表明，在孕期进行抗逆转录病毒治疗、提供最佳的产时护理、分娩时病毒载量<1000拷贝/毫升、对婴儿进行逆转录病毒预防治疗以及避免母乳喂养的情况下，计划阴道分娩可能是安全的。
J Coll Physicians Surg Pak. 2011-6
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